Abstract Ready-to-feed (RTF) Infant Milk Formula (IMF) is currently processed as UHT-sterilized to ensure safety, however, it incurs a significant loss of nutrients due to its high processing temperature (135 °C and above). Therefore, to retain heat-sensitive bioactives, pasteurized RTF liquid IMF could be a pragmatic approach as a new product development which would improve the quality of IMF. In this study, the effect of thermal (63–90 °C) and High Pressure Processing (HPP) of 300–600 MPa at 23 °C on denaturation of native bovine lactoferrin (LF) in reconstituted IMF was studied. Retention of LF was 94.6 and 91.9% at high temperature short time (HTST) conditions of 70.8 °C for 42 and 71 °C for 57 s, respectively, whereas HPP treatments retained only 66–83% LF. Furthermore, LF remarkably maintained its iron binding capacity and storage stability after HTST pasteurization, which together, confirm the possible application of conventional HTST pasteurization to treat LF-added RTF liquid IMF.

AbstractThe purpose of this review is to examine the need for and appropriate level of Fe fortification of infant formula, and to assess any adverse effects of Fe fortification. The appropriate level of Fe fortification of infant formula has been established through studies of Fe absorption or erythrocyte incorporation of Fe, and through clinical trials of formulas with varying levels of Fe that were aimed at preventing the development of Fe deficiency in participating infants. In addition, the effects of varying levels of Fe fortification on the absorption of other minerals and trace elements, and on the incidence of infection and immune function have been studied, as has the effect of adding bovine lactoferrin to formula. Studies of Fe absorption have shown that increasing the level of Fe fortification in formula does not significantly increase the amount absorbed, and that the addition of bovine lactoferrin is unlikely to further increase absorption of Fe. Quite different recommendations for the level of Fe fortification of formula are made in the USA and in Europe. The higher level (12 mg/l) commonly used in the USA is not well supported by the evidence from clinical trials that suggest that lower levels (4 mg/l or less) may be adequate to prevent the development of Fe deficiency. Higher levels of Fe fortification may also interfere with the absorption of other minerals such as Cu and Se. Concerns about potential adverse effects of Fe fortification on immune function and susceptibility to infections have been disproved as have concerns about associated gastrointestinal symptomatology. There are no clearly demonstrated advantages in using ‘follow-on’ formula with high Fe content (up to 13 mg/l) instead of the standard UK formulas with Fe fortification in the range 4–7 mg/l after the age of 6 months, although they may provide an important ‘safety net’ for the prevention of Fe deficiency in communities with weaning diets low in Fe.

Background Previous studies showed that pre- and probiotics may enhance iron absorption. Probiotics combined with prebiotics (synbiotics), including human-identical milk oligosaccharides (HiMOs), are commonly added to infant and follow-up formula (FUF). Whether these additions enhance iron absorption from iron-fortified commercial milk formula is uncertain. Objectives We determined the effect of adding 1) a synbiotic [galacto-oligosaccharide [GOS] + Limosilactobacillus reuteri (L. reuteri)] or 2) the HiMO 2′-fucosyllactose (2′FL) to iron-fortified FUF on iron absorption in young Thai children. Methods In a randomized, controlled, single-blinded (participants) crossover study, 82 Thai children aged 8–14 mo were enrolled to consume single servings (235 mL) of FUF with isotopically labeled ferrous sulfate (2.2 mg iron) with 1) the synbiotic (400 mg/100 mL GOS and L. reuteri DSM 17938), 2) the HiMO 2′FL (100 mg/100 mL), and 3) without synbiotic and 2′FL (control) in random order and a 3-d washout period between administrations. Fractional iron absorption [FIA (%)] was assessed by measuring erythrocyte incorporation of isotopic labels 14 d (n = 26) and 28 d (n = 76) after consumption of the last test FUF. Results Median (IQR) FIA from iron-fortified FUF with the synbiotic [8.2 (5.2, 12.9)%] and with 2′FL [8.4 (5.5, 14.1)%] did not differ from the control FUF [8.1 (4.8,14.7)%] (synbiotic compared with control, P = 0.24; 2′FL compared with control, P = 0.95). FIA from all FUF did not differ when measured after 14 and 28 d of erythrocyte incorporation (Time, P = 0.368; FUF, P = 0.435; Time × FUF, P = 0.937). Fecal pH and hemoglobin were negatively associated with FIA. Conclusions In young Thai children, the addition of a synbiotic (GOS + L. reuteri) or 2′FL to iron-fortified FUF did not impact FIA from a single serving. The study was registered at clinicaltrials.gov as NCT04774016.

Extrinsic staining of teeth due to excessive iron intake has been reported previously in the literature. We describe a 7-month-old infant who presented with extrinsic teeth staining due to inadvertent over consumption of dietary iron. The infant was fed iron-fortified formula and rice cereal. Rice cereal, fortified with iron, was being used as part of a normal infant diet and as a thickening agent when added to the formula for treatment of gastroesophageal reflux. After several months of administration, “blackening” of the infant's teeth was noted by the mother. The stain was removed by the pediatric dentist who simply scraped the affected teeth. No further staining occurred after the amount of dietary iron was reduced.

<h4>Objectives</h4>The aim of this follow-up was to investigate how reduced iron concentration and added bovine lactoferrin in infant formula affect neurodevelopment, iron status, and growth at 12 months of age.<h4>Methods</h4>Swedish healthy term formula-fed infants (n = 180) were randomly assigned to receive, from 6 weeks to 6 months of age, a low-iron formula (2 mg/L) fortified with bovine lactoferrin (1.0 g/L) (Lf+, n = 72), the same formula without lactoferrin fortification (Lf-, n = 72) or a control standard formula with 8 mg/L and no lactoferrin (CF, n = 36). Breast-fed infants were recruited as a reference (n = 72). At 12 months of age, Bayley Scales of Infant and Toddler Development-III (BSID-III), iron status, and anthropometrics were assessed.<h4>Results</h4>There were no intervention effects on BSID-III. Explored outcomes were unaffected by lactoferrin and the two low-iron groups (Lf+ and Lf-) were combined. The low-iron group had lower hepcidin (37.8 vs. 49.4 ng/mL, p = 0.027), compared to the CF group. Furthermore, they had iron status indicators more similar to the breast-fed reference group. The prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) was low with no significant differences among groups. Weight and length were unaffected by intervention, however head circumference was minimally higher in infants fed low-iron formula compared to CF with mean difference (95% confidence interval) of 0.3 (0.0-0.6) standard-deviation-scores, p = 0.03.<h4>Conclusions</h4>Infant formula iron concentration at 2 mg/L was adequate in this population of infants with low risk of ID. Adding bovine lactoferrin did not affect the explored long-term clinical outcomes.

<h4>Background/objectives</h4>Lactoferrin, a key bioactive component in human milk, may bridge functional gaps in infant formula; however, its long-term effects on growth and the gut microbiota in term infants remain underexplored, particularly in real-world settings.<h4>Methods</h4>This real-world evidence (RWE) study assessed the impact of lactoferrin-fortified formula (LF) on infant growth, the gut microbiota, and feeding tolerance compared with control formula (CF) and exclusive breastfeeding (BF). After propensity score matching (PSM) for maternal education level and infant age, 111 matched Chinese infants (37 per group: LF, CF, and BF; age: 6-12 months) were analyzed. Growth was evaluated using WHO Z-scores (WAZ, LAZ, WLZ, and zBMI). The gut microbiota was profiled via 16S rRNA sequencing (<i>n</i> = 81). Feeding challenges were quantified using the Montreal Children's Hospital Feeding Scale (MCH-FS).<h4>Results</h4>The LF group exhibited significantly higher length-for-age Z-scores (LAZ) compared with both the BF and CF groups (<i>p</i> < 0.001), indicating superior linear growth. LF infants also showed reduced MCH-FS scores (18.0 vs. 36.2 in CF; <i>p</i> < 0.001), signifying fewer feeding difficulties. Gut microbiota analysis revealed enrichment of <i>Bifidobacterium breve</i> and butyrate-producing taxa (e.g., <i>Faecalibacterium</i> and Ruminococcaceae), higher alpha diversity, and metabolic divergence, involving enhanced lysine fermentation to acetate/butyrate in LF infants, suggesting a higher level of short-chain fatty acid (SCFA) production. Beta diversity analysis demonstrated that the LF microbiota clustered close to BF.<h4>Conclusions</h4>Lactoferrin-fortified formula was associated with improved linear growth and feeding tolerance while shaping a healthy gut microbiota, showing similarities to breastfed infants' microbiota. These findings support LF fortification as a strategy to improve functional outcomes in formula-fed infants.

Background: Food consumption patterns of young children in China are not well known. Objective: Characterised food groups consumed by infants and young children in urban China using data from the Maternal Infant Nutrition Growth (MING) study. Design: One 24-h dietary recall was completed for 1,350 infants and young children (436 infants aged 6–11 months and 914 young children aged 12–35 months), who were recruited from maternal and child care centres in eight cities via face-to-face interviews with the primary caregiver. All foods, beverages and supplements reported were assigned to one of 64 food groups categorised into the following: milk and milk products, grains, vegetables, fruits, protein foods and desserts/sweets. The percentage of infants and young children consuming foods from specific food groups was calculated, regardless of the amount consumed. Results: Less than half of infants consumed breast milk (47%), whereas 59% of infants consumed infant formula and 53–75% of young children consumed growing-up (fortified) milk. Rice was the number one grain food consumed after 6 months (up to 88%) and the consumption of infant cereal was low. About 50% of infants did not consume any fruits or vegetables, and 38% of young children did not consume any fruits on the day of the recall. Only 40% of all children consumed dark green leafy vegetables and even fewer consumed deep yellow vegetables. Eggs and pork were the most commonly consumed protein foods. Conclusions: The data pr

Background. Iron deficiency continues to be a common problem among infants throughout the world. Iron-fortified formula is effective in preventing iron deficiency but the benefit of iron-fortified cereal is controversial. Methods. We compared iron-fortified rice cereal to unfortified rice cereal in infants who were exclusively breast-fed for more than 4 months and to iron-fortified formula in infants who were weaned to formula before 4 months of age. The design was double blind in respect to the presence or absence of fortification iron in the cereal or formula and included 515 infants who were followed on the protocol from 4 to 15 months of age. Rice cereal was fortified with 55 mg of electrolytic iron per 100 g of dry cereal and infant formula with 12 mg of ferrous sulfate per 100 g of dry powder, levels approximating those in use in the United States. Measures of iron status were obtained at 8, 12, and 15 months. Infants with hemoglobin levels of &lt;105 g/L were excluded from the study and treated. Results. Consumption of cereal reached plateaus at means of about 30 g/d after 6 months of age in the formula-fed groups and 26 g/d after 8 months in the breast-fed groups; these amounts are higher than the 19-g/d mean intake by the 73% of infants who consume such cereal in the United States. Among infants weaned to formula before 4 months, the cumulative percentages of infants excluded for anemia by 15 months were 8%, 24%, and 4%, respectively, in the fortified cereal, unforti

Abstract Background A number of studies have reported on the effects of iron supplementation in low birth weight infants; however, no systematic review of the available evidence has been conducted to date. Hence, we performed a systematic review of the literature to examine the effects of iron supplementation on hematologic iron status, growth, neurodevelopment, and adverse effects in low birth weight/premature infants. Methods We searched the Cochrane Library, Medline, and PubMed for articles reporting on the effects of iron supplementation in low weight infants. The following search terms were used: “preterm born infant(s)/children”; “preterm infants”; “prematurely born children” “weight less than 1500 g at birth”; “born prematurely”; “low birth weight infant(s)”; “infants born preterm”; “prematurity”; “small-for-gestational age”; “very small gestational age infants”; “iron supplementation”; “iron intake”; “iron supplements”; “ferric and/or ferrous compounds”; and “ferrous sulphate/fumarate/sulfate”. Results A total of 15 studies were identified and included in the systematic review. Supplemental iron was given orally or as an iron-fortified formula in 14/15 studies. The duration of treatment ranged from 1 week to 18 months. Iron supplementation significantly increased hematologic measures of iron status (including hemoglobin, hematocrit, serum ferritin) relative to placebo or over time in most studies. All controlled studies that examined iron-deficiency anemia (IDA)/ID re

In the neonatal intensive care unit, adequate nutrition requires various enteral products, including human milk and formula. Human milk is typically fortified to meet increased calorie goals, and infants commonly receive vitamin mixes, iron supplements, and less frequently, thickening agents. We examined the growth of 16 commensal microbes and 10 pathobionts found in the premature infant gut and found that formula, freshly pasteurized milk, and donated banked milk generally increased bacterial growth. Fortification of human milk significantly elevated the growth of all microbes. Supplementation with thickeners or NaCl in general did not stimulate additional growth. Vitamin mix promoted the growth of several commensals, while iron promoted growth of pathobionts. These data indicate that pathobionts in the preterm gut have significant growth advantage with preterm formula, fortified donor milk, and supplemented iron and suggest that the choice of milk and supplements may impact the infant gut microbiota.

To determine the efficacy of iron-fortified infant formula in preventing developmental delays and abnormal behavior.Double-blind, randomized, controlled trial.Urban hospital clinic.A total of 283 healthy, bottle-fed infants from very low income families. Children with prematurity, low birth weight, and major anomalies and those who had received more than 2 weeks of evaporated-milk feedings were excluded. The groups were similar for sociodemographic background variables. Fifty-eight infants (20.5%) dropped out before any outcome data were gathered; 225, 204, 186, and 154 remained at 6-, 9-, 12-, and 15-month assessments, respectively.Iron-fortified formula (12.8 mg iron per liter) versus regular formula (1.1 mg iron per liter).Iron status was measured on venous blood by determination of hemoglobin, serum iron and iron-binding capacity, serum ferritin, and free erythrocyte protoporphyrin values. The Bayley Scales of Infant Development (mental and psychomotor indexes) and two factors of the Infant Behavior Record (test affect and task orientation) were the outcomes of interest.All measures of iron status were significantly different between groups (p < 0.001). Psychomotor development patterns differed between groups (F3,520, 3.4; p = 0.02) with time. Mean values were similar at 6 months but differed at 9 and 12 months of age (p < 0.001), with a decline of 6.4 points in the regular-formula group. By 15 months of age the differences were no longer significant (p = 0.23). Mental de

needed] Infant formula, whether based on cow's milk, soy or rice, is usually fortified with iron and other dietary nutrients. In comparison with cow's milk A milk substitute is any substance that resembles milk and can be used in the same ways as milk. Such substances may be variously known as non-dairy beverage, nut milk, grain milk, legume milk, mock milk and alternative milk. For adults, milk substitutes take two forms: plant milks, which are liquids made from plants and may be home-made or commercially produced; and coffee creamers, synthetic pr Humans may consume dairy milk for a variety of reasons, including tradition, availability and nutritional value (especially minerals like calcium, vitamins such as B12, and protein). Plant-sourced substitutes for dairy milk may be expected to meet such standards, though there are no legal requirements for them to do so. This may result in additives being put into milk substitutes to compensate for the absence of certain vitamins, minerals and/or proteins. Infant formula, whether based on cow's milk, soy or rice, is usually fortified with iron and other dietary nutrients. In comparison with cow's milk, fortified milk substitutes have a comparable amount of calcium, however tend to fall behind in essential vitamin B12 and minerals such as iodine and iron. Legume milks, on average have comparable protein and energy levels to cow's milk, with grain milks, tree nut milks, and seed milks falling behind in this category.

This study was conducted in the graduate laboratories of the College of Agriculture, Tikrit University, and the Animal House, College of Veterinary Medicine, Tikrit University. It aimed to determine the effect of a beetroot-enriched infant formula on growth and vital signs in laboratory rats after 28 days. This study was undertaken in response to the growing need for natural nutritional solutions to address iron deficiency, a prevalent health problem among children worldwide. Laboratory rats were used in this study and divided into two main groups: a healthy control group and an anemic group. Part of the anemic group was fed the beetroot-enriched infant formula, and their weight, blood parameters, and kidney function were measured. The results showed that in the group with anemia, there was a significant decrease in weight gain, iron, and ferritin, and an increase in urea, creatinine, and TIBC compared to the healthy control group. These values were (46.18, 45.10, 40.13, 34.96, 0.80, and 245.54, respectively). However, when infant formula was fortified with beetroot, a significant increase in weight gain, iron, and ferritin was observed (28.34, 41.80, and 33.59, respectively), along with a significant decrease in urea, creatinine, and TIBC (40.72, 0.86, and 352.37, respectively) compared to the anemic control group. These results indicate that red beetroot has a high capacity to enhance nutritional status and improve anemia indicators, making it a natural and supportive food

Infant cereals and formulas are usually fortified with iron to prevent iron deficiency. To enhance iron bioavailability, supplemental ascorbic acid is recommended. Ascorbic acid is considered to be an antioxidant in vivo, but has pro-oxidant effects when exposed to non-protein-bound iron. We measured formation of free radicals in cereals and infant formulas after addition of ascorbic acid. The production of hydroxyl radicals was assessed by hydroxylation of salicylic acid to 2.5-dihydroxybenzoic acid (2,5-DHBA). Production of 2.5-DHBA increased with increasing ascorbic acid doses added. Addition of 0.8 mM ascorbic acid to breast milk produced less radicals (0.03 +/- 0.05 microM) than addition of ascorbic acid to low-iron formula (0.13 +/- 0.08 microM. P = 0.019), medium-iron formula (0.34 +/- 0.12 microM, P < 0.0001) or high-iron formula (0.44 +/- 0.08 microM. P < 0.0001). Even when iron content in breast milk was adjusted to a level comparable with that of formulas, production of 2,5-DHBA was lower. Breast milk seems to contain substances that reduce hydroxyl radical formation.Supplemental ascorbic acid causes hydroxyl radical formation in iron-fortified infant nutrients in vitro.

improve when infant formula is added to their diet. Decision, Decisions Infant formula makers try … (Carnation); Enfamil with Iron and Enfamil Low Iron (Mead Johnson); and Similac with Iron (Ross) Soy … fluoride to make infant formula is partic¬ ularly problematic, since formula is the sole or

improve when infant formula is added to their diet. Decision, Decisions Infant formula makers try … (Carnation); Enfamil with Iron and Enfamil Low Iron (Mead Johnson); and Similac with Iron (Ross) Soy … fluoride to make infant formula is partic¬ ularly problematic, since formula is the sole or